Provider Demographics
NPI:1710350533
Name:SLOAN, KYLE (MA, NCC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:SLOAN
Suffix:
Gender:M
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 BOILERMAKER CT
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-8412
Mailing Address - Country:US
Mailing Address - Phone:219-286-7043
Mailing Address - Fax:219-246-4655
Practice Address - Street 1:2803 BOILERMAKER CT
Practice Address - Street 2:SUITE 1C
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8412
Practice Address - Country:US
Practice Address - Phone:219-286-7043
Practice Address - Fax:219-246-4655
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health